Find a Provider
Request an Enrollment Guide
Enroll Now
417-269-2909

| 

1-855-752-3796
(TTY: 711)

Prescription Drug Resources

CoxHealth Medicare Advantage

Prescription drug search

Find a Pharmacy

Prescription Search

Drug Cost Estimator

You can estimate your drug cost to help plan for future months. To use the Drug Cost Estimator log into the Member Portal.

Diabetic Drug Resource

Review Tier 6 $0 copay insulin, preferred Glucose test strips, and preferred Continuous Glucose Monitoring products.
2026 Diabetic Drug Resource

Important Update: FreeStyle Libre® 2 and 3 sensors are being discontinued by the manufacturer. Cox HealthPlans covers FreeStyle Libre® 2 Plus, 3 Plus, and 14 Day systems. Please talk with your provider about switching to a covered option.

Medication Therapy Management

If you’re in a Medicare drug plan and you have complex health needs, you may be able to participate in a Medicare Therapy Management program.

Medicare Prescription Payment Plan

The Medicare Prescription Payment Plan is a new payment option to help you manage your out-of-pocket Medicare Part D drug costs by spreading them across the calendar year.

Prescription Portal

We partner with MedImpact to administer prescription benefits for our members. MedImpact provides many online tools to help you, including:

  • Locating a participating pharmacy
  • Prescription drug pricing
  • Helpful drug information
  • Mail order administration and ordering

You can view your member benefits by logging in to MedImpact’s secure site at www.elixirsolutions.com. You will need to enter your Member ID number on your identification card and your Date of Birth to log in.

Mail Order Prescriptions

If you rely on regular or long-term medications, there may be a better way to get your prescriptions filled. Birdi pharmacy is a smart, simple way to get your prescriptions delivered to your door. Mail order can save you money on your prescription co-pays with 3 months supply.

How do I get started?

  • Register online at www.medimpact.com or MedImpact mobile app or call Birdi at 866-909-5170 (TTY dial 711)
  • Provide contact details, shipping address and any allergies or medical conditions.

Once you register, you may review medication details, request new prescriptions or refills, and manage payment details. Opt in for phone, email or text updates about your orders. Most orders are processed and shipped within 5 days from receipt of prescription.

How do I set up new prescriptions?

Option #1: Your Doctor Sends Birdi Your Prescription

Your doctor sends your prescription to Birdi electronically or by fax to1-877-395-4836. Birdi can only accept faxes from your doctor. When a new prescription is received from your doctor, Birdi will process the order and ship it to you at the primary address on your patient profile. Controlled substances will not be shipped without your approval.

Option #2: Sign in to Website

Sign in to the MedImpact website www.medimpact.com or mobile app to request a new prescription or transfer one from a retail pharmacy. Choose “Request a Prescription” at the top of “My Prescriptions -> Prescription List” page and follow instructions. Once your new prescription is processed, you can track orders at www.medimpact.com or the mobile app.

Option #3: Mail Birdi Your Prescription

Sign in to www.medimpact.com or mobile app and visit Documents -> Medication Order Form. Send the form with your prescription(s) to: Birdi, PO Box 8004, Novi, MI 48376-8004.

Provider Information

Your provider may send prescriptions by E-prescribe, phone, or fax.

Transition Supply

Under certain circumstances, CoxHealth Medicare Advantage can offer a temporary supply of a drug to you when your drug is not on the Drug List or when it is restricted in some way. Doing this gives you time to talk with your provider about the change in coverage and figure out what to do.

To be eligible for a temporary supply, you must meet the two requirements below:

  • The change to your drug coverage must be one of the following types of changes: The drug you have been taking is no longer on the plan’s Drug List, or the drug you have been taking is now restricted in some way.
  • You must be in one of the situations described below:
  • For those members who are new to the plan:
  • We will cover a temporary supply of your drug during the first 90 days of your membership in the plan. This temporary supply will be for a maximum of 30 days. If your prescription is written for fewer days, we will allow multiple fills to provide up to a maximum of a 30-day supply of medication. The prescription must be filled at a network pharmacy. (Please note that the long-term care pharmacy may provide the drug in smaller amounts at a time to prevent waste.)
  • For those members who are continuing with the plan from the previous year and are taking a drug that will no longer be covered on the plan’s Drug List or have a new restriction.
  • We will cover a temporary supply of your drug during the first 90 days of the plan year. This temporary supply will be for a maximum of 30 days. If your prescription is written for fewer days, we will allow multiple fills to provide up to a maximum of a 30-day supply of medication. The prescription must be filled at a network pharmacy. (Please note that the long-term care pharmacy may provide the drug in smaller amounts at a time to prevent waste.)
  • For those members who have been in the plan for more than 90 days and reside in a long-term care (LTC) facility and need a supply right away:
  • We will cover up to a 31-day supply of a particular drug or less if your prescription is written for fewer days. This is in addition to the above temporary supply situations.
  • Exceptions are available for members who have experienced a change in the level of care they are receiving, which requires them to transition from one facility or treatment center to another. Examples of situations in which members would be eligible for the one-time temporary fill exception when they are outside of the three-month effective date in the plan are as follows:
  • If you enter or leave a long-term care facility
  • If you are discharged from a hospital
  • If you leave a skilled nursing facility
  • If you cancel hospice
  • If you are discharged from a psychiatric hospital on a specialized medication

Call Customer Service at 1(855)476-5985 to ask for a temporary supply. When you are getting a temporary supply of a drug, you should talk with your provider to decide what to do when your temporary supply runs out.

Quality Assurance

We conduct drug utilization reviews for all our members to ensure they get safe and appropriate care. These reviews are especially important for members with more than one doctor prescribing their medications. We conduct drug utilization reviews each time you fill a prescription and with a regular review of our records. During these reviews, we look for medication problems such as:

  • Possible medication errors
  • Duplicate drugs that are unnecessary because you are taking another drug to treat the same medical condition
  • Drugs that are inappropriate because of your age or gender
  • Possible harmful interactions between drugs you are taking
  • Drug allergies
  • Drug dosage errors

If we identify a medication problem during our drug utilization review, we will work with you and your doctor to address the concern.

Extra Help for Part D

Are you a CoxHealth Medicare Advantage (HMO) member or potential member with limited income and resources?

People with limited incomes may qualify for extra help to pay for their prescription drug costs: the low-income subsidy, or LIS.

Additionally, those who qualify will not be subject to the deductible stage (if applicable) or a late enrollment penalty. Many people are eligible for these savings and don’t even know it.

We can help you find out if you are eligible. You may be eligible for lower cost sharing for your prescriptions.

For general information about Extra Help, please call 1-800-MEDICARE (1-800-633-4227) (toll-free) or 1-877-486-2048 (toll-free TTY for the hearing/speech impaired), 24 hours a day, seven days a week. Or visit the Medicare website.

You also may call:

  • Our Customer Service department at 1-855-752-3796 (TTY/TDD users should call 711 or 1-800-735-2966), 8 a.m. to 8 p.m., seven days a week. You may reach a messaging service on weekends from April 1 through September 30 and holidays. or call:
  • Social Security at 1-800-772-1213 (toll-free) between 7 a.m. and 7 p.m., Monday through Friday, or 1-800-325-0778 (toll-free TTY for the hearing/speech impaired). Or visit the Social Security website.
  • Apply for extra help online
2026 LIS Premium Summary PDF

Best Available Evidence (BAE)

If you think you are eligible for Medicare’s extra help and that you are not paying the correct monthly premium or costs for your drugs, you or your appointed representative may be able to correct your Medicare records by providing us with information known as best available evidence (BAE), about your eligibility for extra help.

When we receive and verify your BAE, we will share it with Medicare and update our records within 3 business days. You also will need to provide the information to a network pharmacy when you obtain prescriptions so that we can charge you the appropriate cost-sharing amount until Medicare updates its records to reflect your current status.

Good examples of BAE documents include copies of the following:

  • Your state Medicaid card
  • Your extra help Social Security award letter
  • Supplemental Security Income (SSI) Notice of Award with an effective date
  • A state document that confirms your active Medicaid status
  • Other official state documentation showing your Medicaid status
  • A Home and Community-Based Services (HCBS) Notice that includes your name and HCBS eligibility date

For members who are institutionalized or in a long-term care facility, an appointed representative can provide a copy of the following BAE examples:

  • A remittance from the facility showing Medicaid payment for a whole calendar month with that individual’s name on the statement
  • A copy of a state document that confirms Medicaid payment to the facility for a whole calendar month on behalf of the individual
  • A screen printout from the state’s Medicaid information system showing that an individual’s institutional status based on at least a full calendar month stay for Medicaid payment purposes

You or your appointed representative can mail a copy of your BAE document with your medical or health record number to:

CoxHealth Medicare Advantage
Attn: Enrollments
P.O. Box 5750
Springfield, MO 65801-5750

Or you may fax it to 1-417-269-2949

For more information on Low-Income Subsidy and BAE, please visit the following website (By clicking on the link below, you will be leaving our website):

You must continue to pay your Medicare Part B premium. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, co-payments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year.

Safe Disposal of Prescription Medication

Members of the public are encouraged to safely dispose of unused prescription medications The best way to dispose of most unused or expired medicines (including controlled substances and opioids) is to drop off the medication at a drug take-back site, location, or program. You can also dispose of many medicines at home if a drug take-back option is unavailable. Unused medications should be disposed of as soon as possible to limit the possibility of illegal use.

Flushing or dumping down a drain is NOT the best way to dispose of medication. Sewage treatment systems can’t remove all the medications from the water released into lakes, rivers, or oceans.

So what are the other options?

Medication “Take-Back” Programs – “Take-back” programs allow the public to bring unused drugs to a central location for proper disposal. Call your local government’s trash and recycling service to see if a program is available. In addition:

  • Drug Take-Back Boxes - You can dispose of unused prescription medications free and anonymously at any of CoxHealth Pharmacy drug take-back boxes (available at our Cox North, Turner Center, Wheeler Heart & Vascular and Branson pharmacy locations). For more information please visit https://www.coxhealth.com/services/pharmacy/retail-pharmacy/.
  • You can visit the Missouri Department of Health and Senior Services website for more information and disposal locations https://health.mo.gov/safety/bndd/collection-disposal-info.php.
  • The DEA allows you to mail back unused prescription medications to pharmacies and other authorized sites using packages made available at pharmacies and other locations.
  • Most states have agency collection boxes overseen by law enforcement or pharmacies. Call the DEA’s Registration Call Center to find box locations or other disposal sites: 1–800–882–9539, or go to https://nabp.pharmacy/initiatives/awarxe/drug-disposal-locator/ or https://www.deatakeback.com/
  • Community coalitions and law enforcement in your area may sponsor “medication take-back events” periodically.

Disposal in Household Trash

If these programs are not available in your area, place the drugs in the trash by following these steps:

  • Remove them from their original containers and conceal or remove any personal information, including the Rx number, from the container.
  • Mix the medications with something inedible, such as coffee grounds or kitty litter.
  • Place the empty container and the mixture in a sealed bag or empty can.

For more information, go to https://www.epa.gov/research, https://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/default.htm or https://www.hhs.gov/opioids/prevention/safely-dispose-drugs/index.html.

Limited Income Subsidy

CoxHealth Medicare Advantage (HMO)

Monthly Plan Premium for People who get Extra Help from Medicare to Help Pay for their Prescription Drug Costs

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will generally be lower (if your plan has a monthly premium) than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.

CoxHealth Medicare Advantage is a $0 premium plan. Beneficiaries with LIS will continue to pay $0 for premium.

  • This table shows you what your monthly plan premium will be if you get extra help. The premiums listed are for both medical services and prescription drug benefits.
Your level of extra help CoxHealth Medicare Advantage (HMO) Your Monthly Premium *
100% $0
75% $0
50% $0
25% $0

If you aren’t getting extra help, you can see if you qualify by calling:

  • 1-800-Medicare or TTY users call 1-877-486-2048 (24 hours a day/7 days a week),
  • Your State Medicaid Office, or
  • The Social Security Administration at 1-800-772-1213. TTY users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.

If you have any questions, please call Customer Service at 855-752-3796 (TTY/TDD users should call 711 or 800-735-2966) from 8 a.m. to 8 p.m. Central Time, seven days a week. You may reach a messaging service on weekends from April 1 through September 30 and holidays. Please leave a message and calls will be returned the next business day. You can also reach Customer Service through your Member Portal or the Chat feature on our website (www.CoxHealthMedicareAdvantage.com).

Opioid Information

Drug Management Program (DMP) to help members safely use their opioid medications

CoxHealth Medicare Advantage (HMO) has a program that helps ensure members safely use prescription opioids and benzodiazapines as well as other frequently abused medications. This program is called a Drug Management Program (DMP). If you use opioid or benzodiazapine medications that you get from several doctors or pharmacies, or if you had a recent overdose, we may talk to your doctors to make sure your use of these medications is appropriate and medically necessary. Working with your doctors, if we decide your use of prescription opioid or benzodiazepine medications is not safe, we may limit how you can get those medications.

Treatment Program Services

CoxHealth Medicare Advantage (HMO) offers opioid treatment program services for those affected by opioid and/or benzodiazepine addiction. This includes substance abuse counseling, individual and group therapy, toxicology testing, and certain FDA-approved opioid agonist and antagonist treatment medications. The use of medications, in combination with counseling and behavioral therapies, is often referred to as Medication-Assisted Treatment (MAT). Research has shown that a combination of medication and therapy can successfully treat opioid addiction and help people maintain their recovery. The prescribing of medication to aid in the recovery of addiction helps by decreasing the cravings and normalizes body function. In addition to prescribed medication, a person will receive counseling or therapy to help cope with the mental and emotional aspects of the recovery from addiction. For more information about the opioid and benzodiazapine treatment program services available, please refer to your Evidence of Coverage (EOC), or contact us at 1(855)752-3796 (TTY 711 or 1(800)735-2966).

Opioid/Benzodiazapine Safety Edits at the Pharmacy

To help combat the opioid and benzodiazapine crisis, the Centers for Medicare and Medicaid Services (CMS) require all health plans to continually monitor the use of opioid and benzodiazapine prescriptions. As a result, CoxHealth Medicare Advantage (HMO) reviews every prescription against criteria designed to ensure the safe and effective use of these medication classes. The types of safety edits that we will apply at the pharmacy include the following:

Care Coordination Edit

  • This is an alert that is sent to the pharmacy when a prescription for an opioid or benzodiazapine is submitted, and CoxHealth Plan’s records show that a member has filled other opioid-containing prescriptions written by two or more different prescribers.

Opioid Naïve Edit

  • A limitation on the amount an opioid prescription can be filled for at the pharmacy when it is determined that a member has not filled an opioid claim within the last 120 days.
  • If a member has not received a prescription for an opioid within the last 120 days, the member will be considered opioid naïve, and Medicare requires CoxHealth to limit the initial prescription amount to 7 days, even if the prescription is written for more.
  • After the initial prescription is filled for 7 days, subsequent opioid prescriptions can be filled for up to 30 days as long as the claims history shows a prior opioid claim within the previous 120 days.

Drug Utilization Review (DUR) Edit

  • Specific opioid and benzodiazepine utilization edits are programmed to ensure safe quantities are being dispensed. Additionally, edits are in place to ensure there is monitoring for potential drug to drug interactions that could be harmful.
Scroll to Top
1-855-752-3796
(TTY: 711)
Request an Enrollment Kit
Enroll Now
Search